| NPI | 1568958700 |
|---|---|
| Doing Business As | MICHELE KELLY LPNP, NPP |
| Entity Type | Organization |
| Authorized Contact | MICHELE A. TRIOLO President 631-235-2401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F-400866-1) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 380749) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-07-10 |